Counselling, or 'therapy' as it is commonly known, falls under the umbrella term ‘talking therapies’ and allows people to discuss their problems and any difficult feelings they encounter in a safe, confidential environment. The term can mean different things to different people, but in general, it is a process people seek when they want to change something in their lives, or simply explore their thoughts and feelings in more depth.
A counsellor, or therapist, is not there to sit you down and tell you what to do. Instead, they will encourage you to talk about what's bothering you in order to uncover any root causes and identify your specific ways of thinking. They may then look to create a plan of action to either help you reconcile your issues, or help you to find ways of coping.
Is Counselling And Therapy The Same?
The terms 'counselling' and 'therapy' have become used interchangeably in recent years. As explained by the NHS, “Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues. Sometimes, the term ‘counselling’ is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right.”
Though the terms are often used to mean the same thing, generally counsellors look at specific issues over a shorter time period, whilst therapists often go deeper, looking to uncover the root causes of experiences, and treatment often spans over a longer period of time. It is important to recognise, however, that it is common for counselling to be referred to as 'therapy' and vice-versa. Equally, counsellors may utilise elements of therapy and therapists may counsel.
Brief History Of Counselling And Therapy
The history of treating mental health concerns can be traced all the way back to the ancient Greeks, who were the first to identify mental illness as a medical condition, rather than a sign of disgruntled deities. And while their understanding of mental health treatment wasn’t always spot on, they did recognise the value of encouraging words.
Most people however trace modern-day psychotherapy back to Sigmund Freud in the 1800s. While working as a neurologist with ‘neurotic’ patients, he came to the conclusion that mental illness was the result of keeping thoughts or memories in the unconscious. He developed methods which involved listening and providing interpretations that would bring these memories and thoughts to the surface.
Freud’s work, alongside apprentices such as Alfred Adler, Otto Rank, Karl Abraham, Snador Ferenczi and Carl Jung, led to the development of psychoanalysis and psychodynamic therapy.
Carl Jung was a close colleague of Freud’s, but left to pursue his own theories and methods. Jung’s work drew on both Adler and Freud’s theories with many of his ideas still largely recognised today, such as archetypes, persona, collective unconsciousness and introvert/extrovert personality types.
During the 1950s, another approach was developed - person-centred therapy. Carl Rogers (influenced by Adler and Rank’s work) looked into the transmission of warmth, genuineness and acceptance from therapist to client.
Originally called ‘client-centred’, this approach avoids some of the more complicated constructs of psychodynamic therapy and is at the core of many current counselling practices. Other approaches also started developing under what became a new branch of psychotherapy, ‘humanistic’.
Also in the 50s - and then in the 60s - came some more developments in the psychotherapy world, predominantly in cognitive and behavioural approaches. Albert Ellis developed rational emotive behaviour therapy (REBT) in the 50s and Aaron T. Beck developed cognitive therapy in the 60s. The combination of cognitive and behavioural approaches lead to the development of cognitive behavioural therapy (CBT), an approach that is now widely valued.
Types Of Therapy
There are three main forms of therapy. These are:
- Psychoanalytical / Psychodynamic
When it comes to counselling, there is a range of different approaches or 'therapies' that can be used. The type of therapy used will depend on your counsellor's preferences, the issues you are facing and what type of person you are. Most counsellors won't decide on a therapy type until they have found out more about you, the problems you face and the way you think.
The more common types of therapy include:
Taking an alternative approach to counselling, art therapy encourages clients to use artistic methods to communicate their issues as well as words. This may be in the form of a painting, a sculpture or even a simple drawing. The aim of art therapy is to examine the resulting pieces of art and to interpret their meaning.
The principle idea behind behavioural therapy is that our behaviour is learnt and can essentially be unlearnt. This leads behavioural therapy to focus more on the present as opposed to looking back to the past. This type of therapy is, therefore, best used with those looking to change their behaviour, for example, sufferers of addiction or those with a phobia.
The way we think often leads to changes in our behaviour, and cognitive therapy looks to reconcile issues where they begin - in our thoughts. The therapy looks to address any skewed ways of thinking that may be occurring and eventually aims to replace them with healthier, more positive thought patterns.
Cognitive behavioural therapy (CBT)
CBT looks to combine both cognitive therapy and behavioural therapy in order to tackle the thought process and the resulting behaviour. Focusing on the present, CBT is a practical therapy that aims to break down problems into smaller, more manageable issues. This therapy is especially useful for those with more specific problems as it addresses each emotion separately.
Eye movement desensitisation and reprocessing (EMDR)
EMDR is typically used to treat issues that originated from trauma, though it's starting to be used more widely for issues such as depression and anxiety. The therapy involves recalling the distressing event/feeling while following the therapist’s finger as it moves from side to side. The aim is to reduce the intensity of these memories over time.
The humanistic approach is holistic in style, looking at factors such as free will, creativity and human potential. The therapy type encourages self-exploration, with many varieties focusing on the 'here and now'. Therapies that fall under this umbrella include Human Givens therapy, person-centred therapy and Gestalt therapy.
One of the oldest therapies used in psychology; it was Freud who founded the psychoanalytic technique. The therapy takes a different approach to behavioural and cognitive therapies as it perceives our thoughts to be out of our conscious control. Instead, psychoanalysis believes any psychological issues stem from childhood and need to be addressed in order to be resolved.
How Counselling And Therapy Can Help You & Why It Is Important
The way counselling/therapy can help will depend on the person receiving the treatment. For many, the fact that counselling offers a safe and confidential environment to speak in is all it takes. In life, what we say to others can sometimes have a knock-on effect, altering relationships and the way people see each other. Therapy eliminates this problem and offers you the space and freedom to explore your own thoughts with an unbiased party.
While counsellors/therapists may not give you concrete advice or a checklist of things to do to feel better, what they will do is help you uncover your own insight and understanding of your problems, providing you with the tools which will help you to resolve them on your own.
In the majority of cases, a single session will not be enough to help overcome any issues you're facing. Counselling is a journey, and it takes time and consistency to work effectively. Because of this, many people opt for regular sessions to make the most of the process.
Counselling/therapy can help you understand yourself better and the way you think, which will ultimately help you develop a clearer understanding of your problems. The more armed with information you are, the easier it gradually becomes to navigate your way through any difficulties you are facing, so that eventually you can come out the other side feeling more positive. It can also help you better understand other people's points of view, which can shed light on the way you interpret words or actions.
Where Does Counselling And Therapy Take Place?
Counselling/therapy does not come in a cookie-cutter format and each session is generally tailored to the individual. There is flexibility within this type of therapy that allows for a variety of formats, including:
This is when you make an appointment with a counsellor/therapist to see them in person, usually at their practice. Face-to-face sessions are one of the more popular therapy formats because they provide an opportunity for you to react to any emotions that arise there and then.
Individual or group
You may choose to see a counsellor/therapist by yourself, or if you prefer you could join a counselling support group with people experiencing similar issues. Going to a group session can be helpful if you want to discuss your issues with people who are going through similar problems and you may even gain for yourself a support network. Alternatively, you may wish to see a counsellor/therapist alone to preserve your privacy and concentrate on your own feelings.
For some, telephone counselling offers a helpful alternative to face-to-face counselling. This involves talking to your counsellor/therapist over the phone instead of in person. This form of therapy can be particularly useful for those too busy to attend face-to-face sessions and can be carried out in the comfort of your own home.
Some people prefer to speak to their counsellor/therapist remotely, using video calling technology or emailing them instead. Video calling removes the barrier of distance, allowing you to choose a therapist regardless of location and speak to them from a safe space. Online counselling is an increasingly popular option for individuals and couples counselling.
Counselling can give you the time and space to work through any problems, issues, or worries you may be experiencing. Through working with a professional, impartial, experienced counsellor or therapist, you have the opportunity to open up about things you may feel uncomfortable or not ready to speak about with a loved one or friend.
What To Expect From Counselling And Therapy
If you have decided to try counselling/therapy, you might be feeling anxious about your first session. Making the decision to get help and address the issues you are facing is an important first step and should be commended. Knowing what to expect from a session should help you feel more prepared and less nervous about your first appointment.
In your first session, it's likely that your counsellor/therapist will ask you some questions in order to gain an understanding of what's worrying you and the way your thought processes work. All of the information obtained here will be used to help you in future sessions.
Some questions your counsellor/therapist may ask include:
Why are you seeking counselling?
You'll most likely be asked what it is that has brought you here. This is your opportunity to discuss exactly why you are there and what you hope to gain from it.
What is your current situation and personal history?
It is important to let your counsellor/therapist know your current situation, this includes any day-to-day issues you are facing and even your work and home life. Discussing your personal history will give your counsellor/therapist a chance to understand more about you as a person and why these issues may have occurred.
What symptoms are you experiencing?
Whether these are physical or psychological, it is important to discuss any symptoms with your counsellor/therapist.
It is advised that you be honest and open when answering these questions in order to get the most out of your counselling sessions.
During your experience, you should aim to build a trusting relationship with your counsellor/therapist so that you feel safe and confident discussing your worries. If for any reason you do not feel comfortable talking about your problems with them, it is perfectly acceptable to look for another one.
Your counsellor/therapist should establish some clear boundaries when you begin your sessions that cover the following:
- dates and times of the sessions
- confidentiality agreement
- clarification of the professional nature of the counsellor/client relationship
- how and when they can be contacted outside of sessions
The Counselling Process
Counselling often requires you to discuss upsetting emotions and painful memories. Bringing up these thoughts can feel difficult to start with and initially, you may feel worse. This process is necessary to move forward and in time, you should start to feel better.
To get the most from your sessions you should aim to make them consistent. Some sessions will feel more helpful than others, but it's important to realise that everything your counsellor is doing is designed to help you in the long run, even if it doesn't feel like it in the beginning.
It's also worth remembering that counselling is not a quick fix and that your counsellor will not be able to tell you what to do. The counselling process requires a strong relationship between you and your counsellor and a degree of effort on your part - together these two elements create a successful method to help you resolve your issues.